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Routine dental X-rays are not backed by evidence

arstechnica.com

141–150 of 390 posts

Re: Routine dental X-rays are not backed by evidence

#141
post #134

Earlier quoted context omitted.

It's pretty similar in the UK for private dentistry, x-rays ~£10-30, hygienist/scale/polish ~£50-120, filling ~£70-150, root canal/extraction ~£120-300. Dentist salaries seem to range between £70-200k depending on experience, specialty, etc.

Bone graft and implant for a single tooth can be up to £9K...

For sure, stuff like implants, cosmetic dentistry, braces, crowns etc. still cost a non-trivial amount (though hopefully most are once in a lifetime things).

Re: Routine dental X-rays are not backed by evidence

#142

Earlier quoted context omitted.

Those prices are absurd. My whole annual check up including a digital X-ray, visual inspection, tartar removal, polishing, costs less than that. And that is in high cost Norway.

How much did it cost? If _much_ lower than 200 USD per visit in a very wealthy country, then I assume: (a) dentists don't make very much money. Less than 100K USD? (b) most of the work is done by poorly paid dental assistants (20 USD per hour or less). Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?

I'd say they're in the upper percentiles here in Norway when it comes to making money. Especially if they're having a small privat clinic instead of "renting a chair". So maybe not too much when converted USD, but they're often well off here.

I've had the dentist themselves always do most of the work. The assistant is often shared between multiple dentists in the same office in my experience.

Re: Routine dental X-rays are not backed by evidence

#143

Earlier quoted context omitted.

How about for cavities? I remember reading an article recently about major increases in the number of cavity related treatments because $$$. My kid has had multiple recommendations for cavities and I've got some suspicions about the absolute necessity of all of it.

Fillings are definitely a staple of the procedures a dentist would perform. The article does mention overtreatment, so really depends on your child's caries risk. As mentioned in another comment, healthy dose of skepticism is always required. I usually try to show signs of decay either intraorally or detected on radiographs.

i think parent might have been referring to the radiograph they try to schedule after a cavity filling

Re: Routine dental X-rays are not backed by evidence

#144
post #56

Earlier quoted context omitted.

This guy infamously has a problem with each and every HN user and chooses to display an NSFW image saying such if your request's referrer header has news.ycombinator.com. Don't click.

Sorry, I thought he disabled that.

I believe he did? At least I didn't run into that n a long time.

Re: Routine dental X-rays are not backed by evidence

#145

Earlier quoted context omitted.

Perhaps you'll find it useful that a double-blind study found no improvement in outcome from use of a parachute when jumping out of a helicopter. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/

the studies are about outcomes of parachute use writ-large ("gravitational challenges"), not just helicopters. Only reason I'm being pedantic here is because if the study was in-fact looking at parachutes from helicopters, it could actually be plausible that parachutes had no improvements when used with helicopters. Most, if not all pilots, don't wear parachutes because there's not enough time to jump out of a crashi…

Interestingly helicopters don't fall out of the sky when they lose power. Air moving over the rotorblades causes lift, as they are after all wings. During normal flight the blades are turned by the engine generating lift in the expected way. If you are already above the ground and start descending, the airflow over the blades as you descend will cause them to rotate and generate lift. This is known as autorotation[0], and allows control over the unpowered descending craft.

It is a normal procedure to be able to safely land this way when power has been lost, and in some ways is safer than a gliding fixed wing aircraft as you don't need a runway to land on.

Of course catastrophic failure is possible in a helicopter where the rotorblades can't turn, and then autorotation won't work. But then if a wing falls off a fixed-wing aircraft, they generally can't be controlled (interesting exceptions do exist like with the Israeli F15[1]).

[0] https://en.wikipedia.org/wiki/Autorotation

[1] https://en.wikipedia.org/wiki/1983_Negev_mid-air_collision

Re: Routine dental X-rays are not backed by evidence

#146
post #80

Earlier quoted context omitted.

It's one of these areas where people (including medical professionals) hold strong beliefs, but then it turns out that there are other highly-developed countries where this is not routinely practiced, and the outcomes aren't necessarily different. Routine wisdom teeth removal is not a thing in most of Europe. Another random example are colonoscopies and routine flu vaccines (except for the elderly).

Flu may not be too dangerous in people who aren't elderly but it still sucks. Can a non-elderly, not in any other high risk group, person get seasonal flu vaccination in Europe if they ask for it, and is it covered by European health care systems?

[deleted]

Re: Routine dental X-rays are not backed by evidence

#147
post #80

Earlier quoted context omitted.

It's one of these areas where people (including medical professionals) hold strong beliefs, but then it turns out that there are other highly-developed countries where this is not routinely practiced, and the outcomes aren't necessarily different. Routine wisdom teeth removal is not a thing in most of Europe. Another random example are colonoscopies and routine flu vaccines (except for the elderly).

Flu may not be too dangerous in people who aren't elderly but it still sucks. Can a non-elderly, not in any other high risk group, person get seasonal flu vaccination in Europe if they ask for it, and is it covered by European health care systems?

Not covered, but I can get the shot at nearby pharmacy for 15€.

Re: Routine dental X-rays are not backed by evidence

#148
post #134

Earlier quoted context omitted.

How much did it cost? If _much_ lower than 200 USD per visit in a very wealthy country, then I assume: (a) dentists don't make very much money. Less than 100K USD? (b) most of the work is done by poorly paid dental assistants (20 USD per hour or less). Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?

It's pretty similar in the UK for private dentistry, x-rays ~£10-30, hygienist/scale/polish ~£50-120, filling ~£70-150, root canal/extraction ~£120-300. Dentist salaries seem to range between £70-200k depending on experience, specialty, etc.

Quite happy paying £26.80 / £73.50 for all of that.

It's in a country's interests to help maintain the public's health, and that includes subsidising their dental costs (otherwise, they end up taking up primary care time instead).

Re: Routine dental X-rays are not backed by evidence

#149

Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefull…

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

Not directly related to the topic at hand, but it amazes me how Dutch healthcare insurance does not cover dental care by default, and you have to get an extra package for that. As if dental health is not part of my regular health? Why are teeth treated differently from the rest of the body?

Re: Routine dental X-rays are not backed by evidence

#150

Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefull…

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

to be fair, evidence-based medecine in general is only just starting to take over
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